Treatments for OCD

There are many treatments available to individuals who have been diagnosed with OCD. The most common treatments used to help individuals with OCD are cognitive and behavioral therapies and medication.

The most effective therapeutic approaches for treating OCD focus on addressing thoughts and behaviors associated with OCD. Some treatments can be more behaviorally based, such as exposure and response prevention, whereas others focus more on patterns of thinking associated with OCD, such as cognitive therapy. Oftentimes elements from the two approaches are combined, and when they are, the term cognitive-behavioral therapy (CBT) is used to describe the treatment.

Exposure and response prevention (ERP) is a popular approach to treating OCD because it has been associated with a high success rate (Foa & Kozak, 1996). Exposure and response prevention therapy involves assisting clients in making contact with situations that typically bring about obsessions and compulsions and learning to let their bodies experience discomfort until it dissipates. With the support of a therapist and repeated contact with such situations, individuals typically begin to feel less and less distress. Individuals in therapy learn that they can change their thoughts and sensations without engaging in rituals, which typically are used to reduce distress prior to treatment. Exposure and response prevention works well for many individuals who pursue this treatment, but it is less effective for those who only experience obsessions, but do not engage in compulsive acts (Rachman, 1976a).

Cognitive Therapy (CT) is also used to treat OCD, and can be helpful for those whose main difficulty is obsessive thinking. Individuals with OCD have been found to often experience cognitive biases, such as an inflated sense of responsibility, magnification of potential threats in the environment, thought-action fusion (e.g., “If I think someone might get in accident, it will be more likely to happen,” and “thinking about inappropriate sexual behavior is just as bad as doing it”), and an excessive need to control one’s thoughts (Abramowitz et al., 2006; Wheaton et al., 2010). Cognitive therapists work with individuals with OCD to help them alter these maladaptive thinking patterns, which in turn can lead to a reduction in obsessive thinking and distress.

Medications

Although many people respond to cognitive-behavioral therapy, there are also medications that have been shown to be effective in the treatment of OCD. Sometimes individuals prefer to try medications rather than participating in CBT, but many also find that a combination of CBT and medication provides the best outcome.

References

Abramowitz, J.S., Khandker,M., Nelson,C., Deacon,B.J.,& Rygwall,R. (2006).The role of cognitive factors in the pathogenesis of obsessive–compulsive symptoms: a prospective study. Behaviour Research and Therapy, 44, 1361–1374.

Foa, E. B., & Kozak, M. J. (1996). Psychological treatments for obsessive compulsive disorder.

In M. R. Mavissakalian & R. P. Prien (Eds.), Long-term treatments of anxiety disorders (pp. 285-309). Washington, DC:  American Psychiatric Press.

Rachman, S. J. (1976a). The modification of obsessions: A new formulation. Behaviour Research and Therapy, 14, 437-444.

Wheaton, M.G., Abramowitz,J.S., Berman,N.C., Riemann,B.C., & Hale,L.R. (2010). The relationship between obsessive beliefs and symptom dimensions in obsessive–compulsive disorder. Behaviour Research and Therapy, 48, 949–954.

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